2957例痴呆患者住院费用影响因素分析

Analysis on Influencing Factors of Hospitalization Cost of Patients with Alzheimer's Disease

目的了解痴呆患者住院费用影响因素,为合理控制医疗费用提供科学依据。方法对某三甲医院2016年11月1日-2021年12月31日出院痴呆患者进行回顾性调查,提取患者电子病历中住院费用及其相关信息。采用描述性分析、单因素方差分析、多元线性回归等方法分析住院费用影响因素。结果本研究共纳入2957例痴呆患者,年龄中位数为83岁,住院天数中位数为22天,住院费用中位数为18796.16元。单因素分析显示不同社会因素:性别、职业、住院天数;不同临床因素:转科、手术、死亡、并发症;不同疾病因素:共病数量、入院病因,P<0.05,住院费用差异具有统计学意义。多元线性回归分析提示,对住院费用的影响程度依次为住院天数、手术、死亡、呼吸系统疾病入院、职业、共病数量、循环系统疾病入院、性别、其他疾病入院、并发症、转科,具有统计学意义。结论住院天数、手术、死亡是痴呆患者住院费用的三大影响因素,以缩短平均住院日为基础,推进疾病诊断相关分组、分级诊疗,减少相关住院费用。

Objectives To understand the factors influencing the hospitalization cost of Alzheimer's disease patients,and provide a scientific basis for rational control of medical costs.Methods A retrospective survey based on an electronic health database was conducted on Alzheimer's disease patients discharged from a Three A and Tertiary Hospital from November 1st,2016 to December 31st,2021 to extract patients'hospitalization costs and their related information.Descriptive analysis,one-way ANOVA,and multiple linear regression were used to analyze the factors influencing hospitalization costs.Results A total of 2957 patients with Alzheimer's disease were included in this study,with a median age of 83 years,a median number of hospital days of 22 days,and a median hospital cost of 18,796.16 yuan.Univariate analysis results indicated that there were factors influencing hospitalization cost for patients which were as follows:sociological factors including gender,age,occupation and hospital days(P<0.05 for all);disease factors including number of comorbidities,and disease of hospital admission(P<0.05 for all);and clinical factors including surgery,transfers,concurrent emergencies,death(P<0.05 for all).Multiple linear regression analysis suggested that the degree of influence on hospitalization costs was in the order of hospitalization days,surgery,death,respiratory disease admissions,occupation,number of comorbidities,circulatory disease admissions,gender,other disease admissions,concurrent emergencies,and transfers(P<0.05 for all).Conclusions Hospitalization days,surgery,and death were the three major influencing factors of hospitalization costs for Alzheimer's disease patients.Based on the reduction of average hospitalization days,we promoted disease-diagnosis-related grouping and hierarchical treatment to reduce related hospitalization costs and the burden of family care.